- VernacularTitle:再生障碍性贫血患者铁代谢异常及铁过载状况研究
- Author:
Peng JIN
1
;
Jun SHI
;
Xing-xin LI
;
Ying-qi SHAO
;
Neng NIE
;
Mei-li GE
;
Jing ZHANG
;
Zhen-dong HUANG
;
Jin-bo HUANG
;
Yi-zhou ZHENG
Author Information
- Publication Type:Journal Article
- MeSH: Anemia, Aplastic; complications; physiopathology; Blood Transfusion; Ferritins; blood; Hepatitis; complications; Humans; Iron; blood; metabolism; Iron Overload; physiopathology; Risk Factors
- From: Chinese Journal of Hematology 2013;34(10):877-882
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo investigate the abnormalities of iron metabolism, the prevalence and risk factors of iron overload and clinical characteristics of patients with aplastic anemia (AA).
METHODSA cross-sectional study was conducted on 520 newly diagnosed AA patients.
RESULTSIron overload was observed in 66(13%) of 520 AA patients,in which a higher prevalence of iron overload was seen not only in patients with infections(19/86, 22%)than those without infections (47/434, 11%, P<0.01), but also in patients with hepatitis associated AA(HAAA) (6/22, 19%) than the idiopathic cases (60/488, 12%, P>0.05). Excluded the patients with infections and/or HAAA, 43 of 405(11%)cases had iron overload, including 14 of 248(6%) cases without history of blood transfusion and 29 of 157 patients (18%, P<0.01) with transfusion. In univariate analysis, higher levels of serum ferritin (SF), serum iron (SI) and transferrin saturation (TS) were mainly observed in adult male patients with severe AA (SAA) and significantly upward with increasing blood transfusion (P<0.01). No differences of soluble transferrin receptor (sTfR) were observed between adults and children, males and females, hepatitis and idiopathic AA. However, patients with infections had significantly lower level of sTfR (0.50 mg/L) than cases without infections (0.79 mg/L, P<0.01). The level of sTfR in SAA patients (0.70 mg/L) was only half of that in non-SAA (NSAA) (1.36 mg/L, P<0.01). Patients with increasing blood transfusion had significantly downward levels of sTfR (P<0.01). In multivariate analysis, more than 8 U blood transfusion (OR=10.52, P<0.01), adults (OR=3.48, P<0.01), males (OR=3.32, P<0.01) and infections (OR=2.09, P<0.01) were independent risk factors.
CONCLUSIONAA patients had higher iron burden and were high-risk populations occurring iron overload. The iron overload occurred in 18% of patients with blood transfusion and in 6% of patients without transfusion.